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{{DrugProjectFormSinglePage
|authorTag={{KS}}
|genericName=nicotine patch
|aOrAn=a
|drugClass=transdermal patch
|indicationType=treatment
|indication=withdrawal symptoms, including nicotine craving, associated with quitting smoking
|blackBoxWarningTitle=<b><span style="color:#FF0000;">TITLE</span></b>
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
|fdaLIADAdult===Indication==
*Reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking.
|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Nicotine patch in adult patients.
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Nicotine patch in adult patients.
|offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Nicotine patch in pediatric patients.
|offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Nicotine patch in pediatric patients.
|warnings=If you are pregnant or breast-feeding, only use this medicine on the advice of your health care provider. Smoking can seriously harm your child. Try to stop smoking without using any nicotine replacement medicine. This medicine is believed to be safer than smoking. However, the risks to your child from this medicine are not fully known.


A '''nicotine patch''' is a [[transdermal patch]] that releases [[nicotine]] into the body through the skin.  It is usually used as a method to quit [[tobacco smoking|smoking]].
'''Do Not Use'''
* If you continue to smoke, chew tobacco, use snuff, use nicotine gum, or use another nicotine patch or other nicotine containing products


==General information==
'''Ask a doctor before use if you have'''
[[Image:Nicoderm.JPG||thumb|right|A 21 mg dose [[Nicoderm]] CQ patch applied to the left arm]]
Nicotine patches come in several steps so that users can phase out nicotine use; for example, 21, 14, and 7 mg. A cigarette delivers roughly 1 mg of nicotine, so someone who used to smoke a pack (20 cigarettes) per day or more could start with the "step I" 21 mg patch, while someone who smoked less could start with "step II." After several weeks (6 is recommended) at step I, new non-smokers move on to step II (usually two weeks) and step III (two weeks).


For most users, there are few or no short-term health problems associated with using the patch, so users should not rush themselves through the steps; rather, users can phase out nicotine use on their own schedules.
*Heart disease, recent heart attack, or irregular heartbeat. Nicotine can increase your heart rate.
* High blood pressure not controlled with medication. Nicotine can increase your blood pressure.
* An allergy to adhesive tape or have skin problems, because you are more likely to get rashes.


The nicotine patch was invented by New Mexico Tech neuropsychopharmacology professor Dr. Frank T. Etscorn III; the patent was licensed by Ciba-Geigy, later merged with Novartis.
'''Ask a doctor or pharmacist before use if you are'''
* Using a non-nicotine stop smoking drug
* Taking a prescription medicine for depression or asthma. Your prescription dose may need to be adjusted


==Cost==
'''When using this product'''


In the U.S., the nicotine patch costs roughly $20 to $30 per week, although some municipalities, schools or health plans offer subsidized or free nicotine patches. Depending on local tax rates, the cash cost of the patch compares favorably to the cost of cigarettes.
* Do not smoke even when not wearing the patch. The nicotine in your skin will still be entering your bloodstream for several hours after you take off the patch.
* If you have vivid dreams or other sleep disturbances remove this patch at
'''Stop use and ask a doctor if'''
* Skin redness caused by the patch does not go away after four days, or if your skin swells, or you get a [[rash]]
* Irregular heartbeat or palpitations occur
* You get symptoms of nicotine overdose, such as nausea, vomiting, dizziness, weakness and rapid heartbeat
|storage=●Store at 20-25°C (68-77°F)
|fdaPatientInfo='''If you are under 18 years of age, ask a doctor before use'''
* Before using this product, read the enclosed self-help guide for complete directions and other information
* Stop smoking completely when you begin using the patch
* If you smoke '''more than 10 cigarettes per day''', use the following schedule below:


CVS has begun marketing their own brand of nicotine patches under the name of "Nicotine Transdermal System." They are approximately 25 to 30% cheaper than the [[Nicoderm CQ]] Patches next to which they are shelved.
[[File:Nicotine patch.png|thumb|none|400px|This image is provided by the National Library of Medicine.]]


In the U.K. nicotine patches cost approximately £15 for a week's supply.  For heavy smokers, this compares favourably with cigarettes at £5 for 20 (prices Jan 2007), however light smokers may find that nicotine patches are more expensive than their tobacco habit.
* If you smoke 10 or less cigarettes per day, start with Step 2 for 6 weeks, then Step 3 for 2 weeks and then stop
 
* Apply one new patch every 24 hours on skin that is dry, clean and hairless
==Cost cutting==
* Remove backing from patch and immediately press onto skin. Hold for 10 seconds.
The main difference between each level is not the amount of nicotine placed between the backing and the adhesive, but the size of the patch. This is due to the nature of the adhesive. For the adhesive to maintain its hold properly, the consistency of it must remain the same, thereby allowing only a specific amount of nicotine through. Yet all the patches regardless of size seem to have the same costs. Buying the strongest patches and cutting them into smaller (weaker) patches is a cost cutting method which the manufacturers warn may lead to nicotine leaking and an unstable delivery, there is no evidence to support or disprove this claim.
* Wash hands after applying or removing patch. Save pouch to use for patch disposal. Dispose of * The used patches by folding sticky ends together and putting in pouch.
 
* The used patch should be removed and a new one applied to a different skin site at the same time each day
==Issues==
* If you have vivid dreams, you may remove the patch at bedtime and apply a new one in the morning
===Efficacy===
* Do not wear more than one patch at a time
There have been some [http://whyquit.com/whyquit/A_OTCPatch.html doubts expressed] as to the efficacy of Nicotine Patches, in trials,  the success rates of the control groups was significantly lower than would be expected, the presumption being that the low dose control patches made it harder to quit than normal.
* Do not cut patch in half or into smaller pieces
 
* Do not leave patch on for more than 24 hours because it may irritate your skin and loses strength after 24 hours
Nicotine replacement products (including patches) result in [http://tc.bmjjournals.com/cgi/content/full/12/1/21?ijkey=5.ko5/Oz4yutI 7%] of quitters quitting for at least six months.  Alternative such as high intensity counseling increase quitting rates 300% to [http://surgeongeneral.gov/tobacco/treating_tobacco_use.pdf 22%] (see Table 12)
* To avoid possible burns, remove patch before undergoing any MRI (magnetic resonance imaging) procedures
 
* Stop using the patch at the end of 8 weeks. If you still feel the need to use the patch talk to your doctor.
The very government report that states the 22% figure above actually encourages use of nicotine patches, stating the following. "Numerous effective pharmacotherapies for smoking cessation now exist. Except in the presence of contraindications, these should be used with all patients attempting to quit smoking."
|alcohol=Alcohol-Nicotine patch interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.
 
}}
===Side effects===
{{LabelImage
====Death====
|fileName=Nicotine fig01.jpg
There are a few recorded cases in which tobacco users died from [[heart failure]] after applying multiple patches and then smoking and consuming [[ethanol|alcohol]] at the same time, against doctor's orders.{{Fact|date=February 2007}}  Lawsuits by survivors of such decedents against the decedent's physician and the manufacturers of nicotine patches, cigarettes, and alcohol have generally all been unsuccessful.{{Fact|date=August 2007}}
}}
 
{{LabelImage
====Nightmares====
|fileName=Nicotine ingredients and appearance.png
Patches are intended to be worn for 24 hours at a time, and then be replaced at the same time every day.  However, some individuals wearing the patch while they sleep experience abnormally vivid, erotic, or possibly violent dreams.{{Fact|date=February 2007}} Within this group, some people become acclimated and are not bothered; others find them completely intolerable.  Other people actually enjoy the intense vivid dreaming, experiencing no nightmares or unpleasant dreams, just pleasant dreams of unusual intensity. 
}}
 
For some smokers the solution is simply to wear the patch for approximately 17 hours only, and remove it before bed. There are also several brands which offer sixteen hour patches.  However, because the patches take between two and four hours to achieve peak concentration in the body, this can leave the wearer vulnerable to cravings in the morning, particularly if they don't put on the patch immediately when they wake up. For heavier smokers, or smokers whose prior smoking habits included a smoke first thing in the morning or when getting home from work, the twenty-four hour patches can help avoid times of the day where the patch is not delivering enough nicotine and cravings start.
 
====Itching====
The nicotine and the adhesive can cause swelling, itching and discomfort in the area covered by the patch. Instructions for using the patch indicate it should be placed at a different location every day.  Usually the feeling of itching and mild burning subsides in 30-60 minutes, and is only slightly uncomfortable.
 
==See also==
* [[Smoking cessation]]
* [[Transdermal patch]]
* [[Nicoderm CQ]]
 
==External links==
 
 
[[Category:Tobacco cessation]]
[[Category:Transdermal patches]]
 
[[de:Nikotinpflaster]]
[[nl:Nicotinepleister]]
{{WikiDoc Sources}}

Latest revision as of 17:38, 10 December 2014

Nicotine patch
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Nicotine patch is a transdermal patch that is FDA approved for the treatment of withdrawal symptoms, including nicotine craving, associated with quitting smoking. Common adverse reactions include {{{adverseReactions}}}.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Indication

  • Reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Nicotine patch in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Nicotine patch in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding Nicotine patch FDA-Labeled Indications and Dosage (Pediatric) in the drug label.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Nicotine patch in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Nicotine patch in pediatric patients.

Contraindications

There is limited information regarding Nicotine patch Contraindications in the drug label.

Warnings

If you are pregnant or breast-feeding, only use this medicine on the advice of your health care provider. Smoking can seriously harm your child. Try to stop smoking without using any nicotine replacement medicine. This medicine is believed to be safer than smoking. However, the risks to your child from this medicine are not fully known.

Do Not Use

  • If you continue to smoke, chew tobacco, use snuff, use nicotine gum, or use another nicotine patch or other nicotine containing products

Ask a doctor before use if you have

  • Heart disease, recent heart attack, or irregular heartbeat. Nicotine can increase your heart rate.
  • High blood pressure not controlled with medication. Nicotine can increase your blood pressure.
  • An allergy to adhesive tape or have skin problems, because you are more likely to get rashes.

Ask a doctor or pharmacist before use if you are

  • Using a non-nicotine stop smoking drug
  • Taking a prescription medicine for depression or asthma. Your prescription dose may need to be adjusted

When using this product

  • Do not smoke even when not wearing the patch. The nicotine in your skin will still be entering your bloodstream for several hours after you take off the patch.
  • If you have vivid dreams or other sleep disturbances remove this patch at

Stop use and ask a doctor if

  • Skin redness caused by the patch does not go away after four days, or if your skin swells, or you get a rash
  • Irregular heartbeat or palpitations occur
  • You get symptoms of nicotine overdose, such as nausea, vomiting, dizziness, weakness and rapid heartbeat

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Nicotine patch Clinical Trials Experience in the drug label.

Postmarketing Experience

There is limited information regarding Nicotine patch Postmarketing Experience in the drug label.

Drug Interactions

There is limited information regarding Nicotine patch Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Nicotine patch in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Nicotine patch in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Nicotine patch during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Nicotine patch in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Nicotine patch in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Nicotine patch in geriatric settings.

Gender

There is no FDA guidance on the use of Nicotine patch with respect to specific gender populations.

Race

There is no FDA guidance on the use of Nicotine patch with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Nicotine patch in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Nicotine patch in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Nicotine patch in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Nicotine patch in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Nicotine patch Administration in the drug label.

Monitoring

There is limited information regarding Nicotine patch Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Nicotine patch and IV administrations.

Overdosage

There is limited information regarding Nicotine patch overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Nicotine patch Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Nicotine patch Mechanism of Action in the drug label.

Structure

There is limited information regarding Nicotine patch Structure in the drug label.

Pharmacodynamics

There is limited information regarding Nicotine patch Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Nicotine patch Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Nicotine patch Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Nicotine patch Clinical Studies in the drug label.

How Supplied

There is limited information regarding Nicotine patch How Supplied in the drug label.

Storage

●Store at 20-25°C (68-77°F)

Images

Drug Images

{{#ask: Page Name::Nicotine patch |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Nicotine patch |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

If you are under 18 years of age, ask a doctor before use

  • Before using this product, read the enclosed self-help guide for complete directions and other information
  • Stop smoking completely when you begin using the patch
  • If you smoke more than 10 cigarettes per day, use the following schedule below:
This image is provided by the National Library of Medicine.
  • If you smoke 10 or less cigarettes per day, start with Step 2 for 6 weeks, then Step 3 for 2 weeks and then stop
  • Apply one new patch every 24 hours on skin that is dry, clean and hairless
  • Remove backing from patch and immediately press onto skin. Hold for 10 seconds.
  • Wash hands after applying or removing patch. Save pouch to use for patch disposal. Dispose of * The used patches by folding sticky ends together and putting in pouch.
  • The used patch should be removed and a new one applied to a different skin site at the same time each day
  • If you have vivid dreams, you may remove the patch at bedtime and apply a new one in the morning
  • Do not wear more than one patch at a time
  • Do not cut patch in half or into smaller pieces
  • Do not leave patch on for more than 24 hours because it may irritate your skin and loses strength after 24 hours
  • To avoid possible burns, remove patch before undergoing any MRI (magnetic resonance imaging) procedures
  • Stop using the patch at the end of 8 weeks. If you still feel the need to use the patch talk to your doctor.

Precautions with Alcohol

Alcohol-Nicotine patch interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Nicotine patch Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Nicotine patch Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

{{#subobject: 

 |Label Page=Nicotine patch
 |Label Name=Nicotine fig01.jpg

}}

{{#subobject: 

 |Label Page=Nicotine patch
 |Label Name=Nicotine ingredients and appearance.png

}}

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